Various medical procedures involve the intermittent administration of drugs or fluids through medical tubing to a patient catheter. This allows the patient to be ambulatory between and/or during the medical procedures. Procedures such as the intermittent infusion of antibiotics often involve an intravenously placed catheter. Procedures such as peritoneal dialysis involve a surgically implanted catheter. These catheters terminate outside the patient's skin with tube connectors mateable to the disposable administration tubing set of the fluid or drug sources.
It is very important to protect and disinfect the reusable connector on the patient catheter before and after the procedure so as to reduce the possibility of infection. For example, it is important to reduce the risk of peritonitis infection in peritoneal dialysis patients since peritoneal membrane injury may lead to premature termination of peritoneal dialysis therapy.
Continuous ambulatory peritoneal dialysis (CAPD) allows a patient to perform peritoneal dialysis during a near normal daily routine. The CAPD patient manually performs 3 to 6 fluid exchanges daily wherever he may be. However, due to the number of exchanges and the variety of environments, CAPD has a high peritonitis rate.
There are currently a number of connector caps in use for sealing and protecting the catheter connection after disconnecting from the dialysis solution administration set. Many of the caps require the user to apply a separately packaged disinfectant to the cap in order to disinfect the connector of the peritoneal catheter. This procedure is time consuming, messy and prone to accidential spills. Often, the disinfection is only partially accomplished which increases the chance of infection.
Other connector caps, such as disclosed in the antibacterial protective cap of Genatempo et al., U.S. Pat. No. 4,440,207 are provided with absorbents containing a disinfectant. However, these absorbents may dry out, may not contain enough disinfectant to provide effective disinfection, or do not deliver the disinfectant to the area of contamination. Also these caps tend to leak when being connected.
A few connector caps contain internal reservoirs of disinfectant that can be engaged with the connector to disinfect the connector while it is not in use. The disadvantage of these known connectors is that they require a great deal of manual dexterity to prepare them for use. Furthermore, they create the potential for accidental spillage and/or leakage because the reservoirs are open prior to connection. For example, the antiseptic end cap of Lopez, U.S. Pat. No. 4,432,764 requires the user to unscrew a cover plug from the end cap prior to use. With the plug removed, the reservoir is open and can be accidently spilled prior to or during connection to the catheter.
The antibacterial closure system of Peluso, U.S. Pat. No. 4,624,664 discloses a capping device whose disinfecting reservoir is exposed once a cover plug is removed. The connector cap and cover of Dadson et al., U.S. Pat. No. 4,938,161 likewise discloses a cap whose reservoir is open and prone to accidental spillage prior to or during connection to the catheter connector.
In general, all of the known capping devices require a high degree of manual dexterity by the patient to prepare and properly connect the connector cap. Also, known devices open the antiseptic or drug reservoir prior to connection to the connector. Accidental spillage prior to connection could decrease the effectiveness of the drug or disinfectant or stain the patient and his clothing.
Thus it is a primary object of this invention to provide a self-contained, disposable, easy to use terminal capping device having a drug or disinfectant reservoir for connectable medical tubing.
It is another object that the drug or disinfectant in the capping device be self-releasing so as to minimize accidental spilling or leakage, especially before connections.
It is another object that the device allow the contained disinfectant to cover the outside rim and engaging parts of the connector and diffuse throughout the internal pathway of the connector.
A terminal capping device according to the present invention includes a hollow cylindrical body member having first and second open ends. A first plug seals the first open end such that the plug is inwardly displaceable into the cylindrical body member. A second plug seals the second open end. A chamber is defined by the cylindrical body member and the first and second plugs. A reservoir of disinfecting fluid or drug is provided in the chamber. Axially extending from the first end of the cylindrical body member is a mechanism for engaging and advancing the tube connector into the chamber so as to inwardly displace the first plug into the chamber. This allows dispersal of the reservoir fluid into the tube connector.